COLUMN: Pushing NCTracks over the finish line on July 1

By Aldona Wos , M.D. and Joe Cooper

Published: Tuesday, June 25, 2013 at 05:49 PM.

The Governor has made technology a top priority in government because he recognizes that we cannot provide the best possible service to the citizens of North Carolina if we are held back by outdated IT systems. And when we arrived in Raleigh in January, we couldn’t shy away from some of the largest technology problems facing our state. Since day one, we’ve been focused on the largest IT project in state history — the new Medicaid claims processing system, NCTracks .

Over the past six months, the Department of Health and Human Services (DHHS) and our state’s IT professionals have worked with our vendors around the clock, devoting all available financial and intellectual resources to push this project over the finish line. And on July 1, NCTracks finally goes live.

But why should the people of North Carolina care about the launch of this new government computer system? The reason you should care is simple: NCTracks will allow DHHS, an $18 billion department, to operate more efficiently, which will lead to improved quality of healthcare for our residents.

When it goes live, our NCTracks system will be a national leader — it will be the nation’s first Medicaid-based multi-payer system that will help create efficiencies in DHHS outside of just Medicaid. The new NCTracks program will process and pay more than 2 million claims per week to over 70,000 providers who rely on these payments to provide care to the state’s young, elderly, poor, disabled and mentally ill.

Once implemented, NCTracks will help us make more precise payments and decrease the likelihood of fraud and abuse in the state Medicaid program. It will also help improve customer service and efficiency by reducing paperwork for our state’s healthcare providers and making it easier for them to get reimbursed quickly and accurately through a digital submission process.

The Department has invested thousands of hours and hundreds of people’s efforts during the last few months to get to this point. When a recent report from the State Auditor found several technical issues, our team worked to fix them. In fact, recent simulation testing of 1.2 million claims in the new system showed that they were paid successfully and accurately.

To make this transition as smooth as possible, we need the help of North Carolina’s health care providers. Since January, we have had extensive outreach with provider community to tell them about the new system, train them, as well as answer their questions — from in person and online training sessions to communications via newsletters, email and direct mail. But at this time, only a small percentage of providers have taken advantage of training opportunities — which we are told by the federal government is average — but it means that many providers will have questions after the transition.

The Governor has made technology a top priority in government because he recognizes that we cannot provide the best possible service to the citizens of North Carolina if we are held back by outdated IT systems. And when we arrived in Raleigh in January, we couldn’t shy away from some of the largest technology problems facing our state. Since day one, we’ve been focused on the largest IT project in state history — the new Medicaid claims processing system, NCTracks .

Over the past six months, the Department of Health and Human Services (DHHS) and our state’s IT professionals have worked with our vendors around the clock, devoting all available financial and intellectual resources to push this project over the finish line. And on July 1, NCTracks finally goes live.

But why should the people of North Carolina care about the launch of this new government computer system? The reason you should care is simple: NCTracks will allow DHHS, an $18 billion department, to operate more efficiently, which will lead to improved quality of healthcare for our residents.

When it goes live, our NCTracks system will be a national leader — it will be the nation’s first Medicaid-based multi-payer system that will help create efficiencies in DHHS outside of just Medicaid. The new NCTracks program will process and pay more than 2 million claims per week to over 70,000 providers who rely on these payments to provide care to the state’s young, elderly, poor, disabled and mentally ill.

Once implemented, NCTracks will help us make more precise payments and decrease the likelihood of fraud and abuse in the state Medicaid program. It will also help improve customer service and efficiency by reducing paperwork for our state’s healthcare providers and making it easier for them to get reimbursed quickly and accurately through a digital submission process.

The Department has invested thousands of hours and hundreds of people’s efforts during the last few months to get to this point. When a recent report from the State Auditor found several technical issues, our team worked to fix them. In fact, recent simulation testing of 1.2 million claims in the new system showed that they were paid successfully and accurately.

To make this transition as smooth as possible, we need the help of North Carolina’s health care providers. Since January, we have had extensive outreach with provider community to tell them about the new system, train them, as well as answer their questions — from in person and online training sessions to communications via newsletters, email and direct mail. But at this time, only a small percentage of providers have taken advantage of training opportunities — which we are told by the federal government is average — but it means that many providers will have questions after the transition.

It is important to set realistic expectations about what is going to happen as we transition to the new system. We know from the experiences of other states that have implemented Medicaid payment platforms that there will be an initial rough patch of 30 to 90 days as providers get used to using the new system. We have set up a call center with additional staff and expanded hours to help with the influx of questions, but providers may experience longer-than normal wait times. We have even cancelled many Fourth of July vacations at DHHS, and we also have people on standby to help with call volume if necessary.

Additionally, an unusually high number of providers may try to submit their claims on July 1, which could result in additional strain being put on the system. We will be monitoring performance on a real time basis and will be making adjustments to stay ahead of the load. And despite thousands of tests being run on the system, we will likely uncover additional changes that need to be made after we go live. In talking to states that have had very successful changeovers, each of them have shared with us that these issues are expected. To be fair, most of the issues were cosmetic in nature in that they didn’t impact the state’s ability to process claims. We will be monitoring the situation from a central command center, and we have a team in place to resolve issues as swiftly as possible.

We’ve offered free training for providers over the past couple of months to help them enroll in and use the new system. For providers who missed the instructor-led training sessions, online courses are available 24/7 to help them prepare for the switch. After the new system goes live, field training representatives around the state will also provide in-person training, if needed. Providers can learn more about training by going to nctracks.nc.gov, or by calling 1-866-844-1113.

Wos is the N.C. Department of Health and Human Services Secretary. Cooper is Chief Information Officer for the department.